Comparison of breast milk and sucrose in neonatal pain relief and coping with stress of ROP examination using ALPS-Neo

Background: Examination for retinopathy of prematurity (ROP) is one of the procedures that can be stressful for neonates admitted to a neonatal intensive care unit. This study compared breast milk and sucrose in pain relief and coping with the stress of ROP examination using the Astrid Lindgren and Lund Children�s Hospital Pain and Stress Assessment Scale for Preterm and Sick Newborn Infants (ALPS-Neo). Methods: The present study was carried out on a total of 63 preterm infants (including breast milk group n=21, sucrose group n=21, and distilled water group n=21). The neonates were given 0.5 ml/kg of breast milk, sucrose, or distilled water 2 min before the examination. The ROP eye examinations were video recorded from 5 min before to 15 min after the examination, and infants� pain and stress levels were assessed using the ALPS-Neo by two blinded evaluators 5 min before, during, and 5, 10, and 15 min after the examination. Results: No statistically significant differences were observed during the examinations in the mean scores of the ALPS-Neo among the three groups (P>0.05). However, there were statistically significant differences among the three groups after the examinations (P<0.05) and in the mean duration of stress adaptation (P<0.05). The duration of stress adaptation in the breast milk group was 11.4 min on average which was lower than that reported for the other groups. Conclusion: Breast milk was more effective in the reduction of pain and stress after ROP examinations, compared to sucrose or distilled water. © 2021 Mashhad University of Medical Sciences. All rights reserved

Chemoreduction in the management of intraocular retinoblastoma using new international classification

Purpose: To evaluate the effectiveness of chemoreduction (CRD) for globe saving in patients with intraocular retinoblastoma. Methods: In this interventional case series all patients with intraocular retinoblastoma were included and classified according to the international classification of retinoblastoma (ICRB) from group A to E. Six cycles of intravenous Vincristine, Etoposide and Carboplatin (VEC) were used for all groups, except for unilateral group A and E. After reduction of tumor volume adjuvant therapy was applied in all cases. Main outcome measure was CRD success, defined as globe salvage by avoidance of external beam radiotherapy or enucleation (EBRT). Results: Forty-three eyes from 31 patients were enrolled, 12 patients had bilateral involvement. 5 eyes were in group A, 7 in group B, 6 in group C, 8 in group D and 15 in group E. Thirty-one eyes were treated with VEC protocol and aggressive focal consolidation. Successful response was observed in 24 patients, de-novo recurrences occurred in 6 eyes that treated with additional VEC and neoadjuvant therapy. Success rate was 100 for groups A, B and C and 55 for group D during 6-18 months (mean=11.4 months) follow-up. Overall 19 eyes were enucleated (group E=15 and group D=4). Conclusion: CRD is an effective treatment modality for globe salvage in patients with intraocular retinoblastoma with a high success rate in groups B and C, and an acceptable success in group D. © 2010 by the Iranian Society of Ophthalmology

Prevalence and Risk Factors of Retinopathy of Prematurity in Iran

Purpose: The present study aimed to evaluate the frequency and risk factors of retinopathy of prematurity (ROP) among Iranian infants. Methods: A retrospective cohort study was conducted on infants who had undergone screening for ROP at Farabi Eye Hospital, between March 2016 and March 2017. Data were analyzed based on the presence of extreme prematurity (gestational age ≤ 28 weeks), extremely low-birth-weight (≤ 1000 g), and multiplegestation (MG) infants. Results: The prevalence of ROP was 27.28% (n = 543) among all screened infants, 74.4% for extremely preterm (EP) infants, 77.5% for extremely low birth weight (ELBW) babies, and 27.25% for infants from MG pregnancies. On multivariate analysis, gestational age, birth weight, and history of transfusion (P &lt; 0.0001, P &lt; 0.0001, and P = 0.04, respectively) were found to be significantly associated with ROP. More advanced stages of ROP (P &lt; 0.0001) were observed in EP and ELBW infants. Birth weight (P = 0.088), history of transfusion (P = 0.066), and intubation (P = 0.053) were not associated with increased risk of ROP in EP infants, while gestational age (P = 0.037) and history of transfusion (P = 0.040) were significant risk factors for ROP in ELBW infants. Gestational age (P &lt; 0.001) and birth weight (P = 0.001) were significantly associated with ROP in infants from MG pregnancies in multivariate analysis. Conclusion: ROP remains a commonly encountered disease, especially in ELBW and EP infants. The history of transfusion may have a role in stratifying the risk for ROP and guiding future screening guidelines